Recent developments in coronary atherectomy.

Abstract

Percutaneous coronary atherectomy (PCA) is one of the newest treatments for coronary artery disease. In this technique, arterial plaque is mechanically removed from the interior of the artery by a tool located on the tip of a catheter placed inside the coronary artery nonsurgically. Clinical studies of several coronary atherectomy devices are in process in the United States and abroad. As atherosclerotic material is removed or debulked, abrupt reclosure or restenosis rates may potentially be lower compared with conventional percutaneous transluminal coronary angioplasty (PTCA). PCA may also clear longer and more diffuse lesions, with long-term clinical success, than are successfully being treated by PTCA. Due to the rigidity of the atherectomy catheter, only lesions in major coronary arteries may be approached with these devices at present. It is hoped that PCA may supplement current methods of treating coronary artery disease, including coronary artery bypass graft surgery and PTCA.